This report describes the Improvement Collaborative approach as adapted by the USAID-funded Quality Assurance Project and Health Care Improvement Project. The paper draws on the lessons learned in implementing over 35 improvement collaboratives in 14 developing and middle income countries. It describes seven essential features for the successful implementation of an improvement collaborative and the key activities that occur during each of a collaborative’s phases: the preparatory phase, the implementation/demonstration phase, and the spread phase (2008, 20 pages).